Pharmacology Final Key Concepts Flashcards
Contraindications for Calcitonin?
Hypersensitivity to fish products
How does Calcitonin work?
Treats Osteroporsis, and Biphosphates do too. It is a thyroid horomone that inhibits the action of PH and stops it from being absorbed by the bone. Regulates calcium and bone metabolism
How to store Calcitonin?
Store unopened bottle (nasal drug formulation) in the refrigerator between 36 and 43 degrees F.
Once the pump has been activated, store at room temperature
What should the nurse be aware of with calcitonin?
Causes serum calcium level to drop, which results in tetany and cardiac arrhythmias.
How do the biphosphates work?
Inhibits normal and abnormal bone absorption.
Treats hypercalcemia to increase bone resorption of calcium, and in treating osteoporosis.
Patient teaching for Biphosphates
Take each tablet upon rising in the morning with a full glass of plain water (6-8 oz), and at least 30 minutes before ingesting any other medicaions, food, or beverages.
Vitamin D is needed in order for it to be effective.
Must not take it before going to bed or before getting out of bed in the morning.
Differences between Calcitonin and Calcitriol?
Calcitonin is a peptide hormone that limits calcium levels by inhibiting the intestinal uptake and bone release.
Calcitriol is a form of vitamin D that stimulates the intestinal absorption of calcium, stimulates calcium’s release from the bone, and stimulates calcium’s reuptake by the kidney.
How does Prazosin work to treat BPH?
Selectively and competitively blocks postsynaptic alpha-1 adrenergic receptors,decreaes sympathetic tone anddilates arterioles and veins.
This results in decreased peripheral resistence and decreased blood pressure.
Wat drugs are used in shock to raise vital signs?
Dopamine & Epinephrine, which are adrenergic agonists so they stimulate the sympathetic nervous system.
What do adrenergic agonists or anticholinergics do to the body when stimulated? (sympathetic nervous system stimulation)
Pupils dilate Sallivary glands secrete fluid Heart rate increases, Heart contractility increases Coronary arteries dilate Trachea and bronchioles dilate Blood vessels in the skin and mucous membranes constrict Sweat is produced GI motility and tone decreases GI sphincters contract Ureter and bladder relaxes Ejaculation is stimulated in bed
What do cholinergic agonists and adrenergic antagonists do to the body?
Pupils constrict Tears flow Salivary gland secretes watery fluid(instead of viscous fluid in sns) Trachea and bronchioles constrict and secretions decrease GI glands produce more secretions GI motility increases (incontinence?) Lower colon contracts Ureters and bladder contract Penille erection stimulated in mend
What does Methimazole do?
Inhibits the synthesis of the thyroid hormones (T3 and T4) so they are not produced.
Therefore it lowers thyroid levels and is used to treat hyperthyroidism in Graves Disease
Nursing considerations for Methimazole?
Administer around the clock at 8-hour intervals
What other thing can Methimazole be used for?
Used to prepare someone for having their thyroid removed (thyroidectomy) in order to get them used to having a lower function of thyroid and less/ thyroid hormone circulating in the body.
If someone complains of being depressed, what could this possibly mean?
Hypothyroidism so assess for it.
Lethergy weight gain anxiety impaired memory constipation hypotension bradycardia intolerance to cold loss of hair decreased sexual function menstrual irregularities infertility edema of the hands and feet and face, pale and rough skin, thickened tongue,and a husky voice
are what you would see in what condition?
Hypothyroidism
Tachycardia, signs of an overactive cellular metabolism of all body systems, tachycardia, palpitations, hypertension, increased body temperature, heart intolerance, weight loss, ameonorrhea and goiter are clinical manifestations of what disease?
Hyperthyroidism
What is Levothyroxine used for?
Replacement therapy in hypothyroidism
Also can be used for subacute thyroiditis, or for the suppression of thyroid stimulating hormone in managing hypothyroidism secondary to thyroid cancer, and in treating myxedma coma.
How does Levothyroxine work?
Replaces natural thyroid hormone
What adverse effects can Levothyroxine do?
Cause symptoms of HypERthyroidism. Fast heart rate etc
Basal Insulin
the continuous secretion that maintains glucose homeostasis, that is, the
body’s baseline level of insulin.
Correctional Insulin
In addition to the basal and prandial doses, patients with diabetes
who are ill and hospitalized may also require some correctional (or supplemental) insulin doses to correct any elevations in blood glucose, with the goal of keeping the blood glucose close to normal at all times, because the physiologic stress of illness increases glucose levels. Some medications can also increase glucose levels
Diabetes Mellitus
Type 2 diabetes is the result of insulin resistance by the tissues and usually a decrease in insulin production. Abnormalities of carbohydrate, fat, and protein metabolism occur in type 2 diabetes. Type 2 diabetes is linked closely to obesity, sedentary lifestyle, and lack of physical activity; scientific experts declare that the dramatic rise in the number of patients with this type of diabetes is attributable, in great part, to America’s weight problem
Diabetic Ketoacidosis
Because the circulating glucose is not accessible to the cells, the
body mistakenly interprets this to mean that there is not enough glucose and thus initiates two other processes to gain energy: breaking down lipids and breaking down proteins. The increase in lipid metabolism leads to an increase in ketoacids, causing ketoacidosis (metabolic acidosis of diabetes). The breaking down of proteins leads to muscle wasting, constant weakness, and weight loss. By the time the signs and symptoms of type 1 diabetes appear, most pancreatic beta cells have been destroyed. Occurs in type 1 diabetes
Gestational diabetes mellitus
occurs when a woman’s pancreatic function is not sufficient to overcome the insulin resistance created by the anti-insulin hormones secreted by the placenta (e.g., estrogen, prolactin, cortisol, and progesterone), as well as the increased fuel consumption needed for the mother and the fetus. Diagnosis and treatment are essential because the severe hyperglycemia that can result is associated with increases in the incidence of preeclampsia, fetal macrosomia (i.e., large infants), birth trauma, and perinatal mortality
Gluconeogensis
Glucocorticoids cause an increase in gluconeogenesis and a decrease in glucose utilization, causing HYPERGLYCEMIA to occur.
Glycogenolysis
breakdown of glygogen to glucose
Glycposylated Hemoglobin
Hemoglobin molecules react with glucose molecules and form glycosylated hemoglobin. This process is increased when blood glucose levels are elevated, such as in diabetes. Because this reaction of glucose with hemoglobin will last the life of the red blood cell it is possible to determine a patient’s blood glucose level
Prandial Insulin
Insulin that is secreted in response to meals
Metabolic Syndrome
This syndrome is a combination of conditions, namely insulin resistance with a compensatory hyperinsulinemia to maintain glucose homeo-stasis; obesity (especially abdominal or visceral obesity); dyslipidemia characterized by high triglycerides, low high-density lipoproteins (HDLs), or both; prothrombotic state (e.g., high brinogen or plasminogen activator inhibitor); pro-in ammatory state (e.g.,elevated high-sensitivity C- reactive protein in the blood); and hypertension (130/85 mm Hg or greater).
Non ketotic hyperglycemia
Insulin is present but not as effective
Dawn Phenomenom
when blood glucose levels are at their highest between 5 am and 6 am. The release of growth hormone overnight is believed to produce this increase in blood glucose. Dawn phenomenon is treated by providing larger doses of intermediate-acting insulin at bedtime to prevent early-morning elevations of glucose.
The Somogi Effect =)
The Somogyi effect also produces early-morning hyperglycemia, but the precipitating factor is actually a hypoglycemic event sometime after midnight. The body compensates for the low blood glucose by using counter-regulatory hormone release, directing the liver to release glucose to restore the glucose level to normal. When the body overcompensates, rebound hyperglycemia occurs. The Somogyi effect is treated by lowering the insulin dose, increasing the dietary intake at bedtime, or both.
Type 1 Diabetes
an autoimmune disorder characterized by the destruction of the insulin-secreting beta cells in the pancreas, leading to absolute insulin deficiency.The body’s reserve of insulin is depleted, resulting in hyperglycemia (abnormally high blood glucose). Because the circulating glucose is not accessible to the cells, the body mistakenly interprets this to mean that there is not enough glucose and thus initiates two other processes to gain energy: breaking down lipids and breaking down proteins.
The increase in lipid metabolism leads to an increase in ketoacids, causing ketoacidosis (metabolic acidosis of diabetes).
The breaking down of proteins leads to muscle wasting, constant weakness, and weight loss.
By the time the signs and symptoms of type 1 diabetes appear, most pancreatic beta cells have been destroyed.
What is Glucagon?
Glucose-elevating agent that accelerates hepatic glyconeogenesis, increasing blood glucose levels. Glucagon also plays a role in regulating the blood glucose level. Glucagon is a small protein hormone, and declining blood glucose levels stimulate its release from pancreatic islet alpha cells. Sympathetic nerve impulses, exercise, infection, and trauma also stimulate its release. In the liver, glucagon stimulates glycogenolysis and gluconeogenesis, resulting in a release of glucose into the blood.
What might need to accomany glucagon in someone with hypoglycemia and why?
A carbohydrate, because it is short acting! And you need something that will sustain the glucose level for longer.
Differences in adverse effects in Oral Insulin vs. Subcutaenous Insulin
Repetive Subcutaenous injections of insulin intomthe same injection site can cause disturbances in fat metabolism. It causes Lipodystrophy as an adverse effect, which can present as either lipidstrophy, which causes SC fat to break down, or lipid hypertrophy, which causes additional fat deposits at a particular site.
They both delay insulin absorption, which can mess up pharmacotherapeutics. Sub-Q is also short acting and it can cause weight gain.
Oral insulin can cause hypoglycemia.
What are sub-Q and oral insulins prescribed this way?
Sub-Q insulin, which is regular insulin, has a quick onset and short duration, which means that it can be given to a patient several times a day.
With IV insulin, up to 80% but usually 20-30% of the insulin is lost because it is absorbed into the plastic tubing set.
What assessment would you complete for someone taking regular insulin?
Nurse should assess for changes in their normal routine, such as missing meals or unexpected exercise.
Exercise can decrease the need for insulin.
The nurse should ask about the patients usual activity level, occupation, amount of recreational activities, and daily exercise.
Also should assess typical eating habits.
You might need to increase the amount of times that they check their blood glucose level or increase the sliding scale.
What is the result of missing dosages of antibiotics and not taking antibiotics as prescribed?
Causes antibiotic resistence which allows organisms to repopulate and re-establish an infection
What causes Multiple Drug resistant Mycobacterium Tuberculosis?
Inadequate drug therapy, which can include a dose that is too low, the duration of therapy being too short, or the patient stops taking the medication as prescribed.
What are a culture and sensitivity?
Culture determines what the microbe is, Sensitivity determines which antimicrobial agent will be therapeutic.
Most important patient education in antimicrobial therapy?
Complete the entire course of antibiotics, take the prescribed dose at the prescribed intervals.
What is lsoniazid used for?
Prophlyaxis and management of TB
Important concern for patients taking Isoniazid?
Causes liver toxicity/Hepatotoxicity!
Isoniazid contraindications
Acute hepatic diseases
How to administer Isoniazid
On an empty stomach
What causes multindrug resistant TB???
Nonadherence to therapy
How long to patients who are on multi drug therapy for TB have to have therapy?
6-24 Months
When Glucocorticoids are used to treat asthma, what side effects do they cause?
Suppression of HPA axis which may lead to secondary adrenal insufficiency. Abrupt withdrawl may cause adrenal insufficiency too.
So they must be withdrawn gradually‘to prevent this!!!
*Can also cause Cushingoid characteristics which includes the redistribution of fat deposits (such as getting a buffalo hump, moon face, and trunkal obesity) * also vision changes and muscle wasting.
Prednisone can cause:
Long term can also cause osteoporosis in women which puts patients at risk for fractures, bone loss, and can als impair glucose tolerance in patients with type 1 and 2 diabetes..
How do glucocorticoids affect people with diabetes??
Prednisone, the prototype, can affect Glucose tolerance.
Patients with diabetes taking this drug may need to change their diet or hypoglycemic therapy to maintain theirndrug sugar.
Can also alter glucose tolerance tests.
Glcucocorticoids can also do what to glucose ?
Increase gluconeogenesis and decrease glucose utilization, which causes hyperglycemia!!!
Patient education for those using inhalers?
Clean/Rinse equipment after each use to decrease the risk of infection
What can the overuse of laxatives do to the GI sphincters?
Can cause incontinence
Infants skin permeability is what compared to an adult? How does this affect drug absorption?
Infans skin permeability is greater and they have an increased body surface are which increases the absorption of topical agents.
This is important bc it may result in adverse effects that do not usually occur in an adult patient.
Patient on an aminoglycoside–> what adverse effect?
Nephrotoxicty —-> Decreased urine output
Drugs that treat peptic ulcer disease- How do they work?
Antacids neutralize excess acidity H2 receptor antagonists suppress gastric acid production Bismuth triple therapy treats ulcers caused by H. pylori.
How do proton pump inhibitors work in treating peptic ulcer disease?
AKA Omeprazole, works by the blocking the final step of gastric acid production; they inhibit both basal and stimulated acid secretion.
Proton Pump inhibitors suppress the H+/K+ ATPase enzyme system.
Intragastric pH is therefore elevated, and as a result, blood flow in the antrum, pylorus, and duodenal bulb is decreased.
Omeprazole increases serum pepsinogen levels and decreases pepsin activity. The increases in gastric pH are associated with increased numbers of nitrate-reducing bacteria and elevated nitrate concentrations in gastric juice in patients with gastric ulcers. Serum gastrin levels increase as acid secretion is inhibited.
How do Prokinetic agents work?
Prokinetic agents work by sensitizing tissues to the effect of acetylcholine. It has the cholinergic-like effect on the upper GI tract of stimulating motility but does not stimulate gastric, pancreatic, or gallbladder secretions.
Alsp increases peristalsis of the duodenum and jejunum, thus shortening the transit time through the stomach and small intestine.
It also increases the tone of the lower esophageal sphincter, increases gastric contractions, and relaxes the pyloric sphincter.
What patient teaching should be required for Pseudoephedrine?
Take as prescribed to avoid rebound congestion, caution them about taking other OTC drugs that might have sudofed in them.
Monitor them for rebound congestion, sedarion, dizziness, weakness, tremor, urinary retention.. Etc.
By the end of therapy they should be free of nasal congestion and free from potential CNS effects.
How does Sudafed (Pseudoephedrine) work?
Mimics the action of the sympathetic nervous system and achieves is nasal decongestant effects by causing vasoconstriction in the nasal mucous membranes.
Shinking decreases the membrane size and promotes sinus drainage and improved airflow.
How would you prevent an asthma attack?
Administer the inhaler/drug 30 mins before exercising
How does Acetylcysteine work?
Its a Mucolytic. It is used to liquefy thick, tenacious secretions.
For what would the use of acetylcysteine be contraindicated?
Patients with an inability to cough.
Could be due to having an NG tube or not having a cough reflex.
What is the antidote for Acetaminophen overdose?
Acetylcysteine
Antidote for Morphine/Opiate overdose?
Narcan
What triggers usually cause asthma attacks?
Exercise and foreign allergens/allergic reactions
Rescue meds vs. preventative meds
Rescue meds are quick acting bronchodilators, usually given through an inhaler or a nebulizer
Preventative are usually inhaled corticosteroids, are not given through an inhaler or nebulizer, long acting.
What is Theophylline used for?
Symptomatic relief of bronchocontriction and bronchospasm
Contraindications for Theophylline?
Status Asthmaticus and peptic ulcer
Patient education for Theophylline
Most severe adverse effect is seizures and arrhythmias. Take drug exactly as prescribed to avoid adverse effects
Major contraindication for Ipratropium Bromide?
Hypersensitivity to flurocarbons or legumes such as soybeans or peanuts
How does Albuterol work?
It is a Bronchodilator.
It is a moderately selective beta- 2 Agonist. Selectively stimulates receptors of smooth muscle in the lungs, the uterus, and the vasculature that supplies skeletal muscle.
The result of it binding to beta -2 receptors in the lung is the Relaxation of Bronchial smooth muscle.
This relieves bronchospasm, reduces airway clearance, facilitates mucus drainage, and increases vital capacity.
Maximizing therapeutic effects of Acetylcysteine?
Refrigerate the solution and use it within 96 hours
What is Cromolyn sodium
Prophlyaxis of allergic symptoms, including asthma.
Can cause a dry throat, cough and wheezing as adverse effects.
Most serious adverse effects are bronchospasm and anaphylaxis
How does Cromolyn sodium work?
It is a mast cell stabilizer that stablizes mast cells and prevents rupture when the cells are exposed to an antigen. This stops the release of histamine, serotonin, bradykinin, and leukotriene, all of which produce bronchspasm.
What adverse effect can Zafirlukast cause?
Hepatic failure and Churg-Strauss syndrome
What are the contraindications for Zafirlukast?
Hypersensitivity to povidone, lactose, titanium diozide, and cellulose; breast feeding.
Common side effects of Zafirlukast?
Headache, gastritis, pharyngitis, and rhinitis.
What assessment would you do before giving Digoxin?
Pulse + Blood Pressure
What would you do if a patients pulse was under 60 and you were supposed to give them Digoxin?
Hold the drug and call the doctor
What does Nitroglycerin do?
Reduces Angina Pain
IV Nitroglycerin is used for what?
To Decrease Blood Pressure
What is the most common adverse effect to be expected in Nitroglycerin?
Headache Followed by Hypotension
Nursing actions for Nitroglycerin?
- Remove the patch on for 12 hours, off for 12 hours.
- Keep in the original dark bottle, out of sunlight
- Keep away from moisture (keep cap sealed when not using it)
When giving for Angina:
Give 3 times every 5 minutes for up to 15 minutes, have the patient rest or lie down during an anginal attack.
What happens if an angina happens at night?
Beta blocker or Calcium Channel Blocker should be considered
What should the nurse do before giving Nitroglycerin?
Take and monitor blood pressure, keep the patient lying down to prevent orthostatic hypotension
Patient Teaching for Heparin?
- Use a Soft Toothbrush
- Use an Electric Shaver
- Education about Preventing Falls and Injury
What would you monitor for Heparin?
APTT
What should the aPTT be for those taking Heparin?
1.5- 2 times the upper limit lf the normal range.
So its higher than a normal person would be ideally
What is the antidote for Heparin Overdose?
Protamine Sulfate
What Nursing Assessment would you do for a patient on Heparin?
Assess for Bruising, Bleeding, look their urine to see if there is any blood in it, and look at their stool to see if there is any blood in their feces.
Ask the patient if they normally engage in behaviors where bumping or body injuries usually occur?
Are they at risk for injury?
How is Heparin administered?
IV or Subcutaneously
What does Heparin Do?
It is an Anticoagulant that prevents the formation of clots and prevents the extenstions of clots.
It has no effect on existing Blood clots!
Can Heparin be used during pregnancy?
Yes
Patient teaching for Heparin?
Prevent falls, report any blood in the urine or stools or bleeding from gums, nose, vagina or wounds.
How would you calculate the therapeutic range for Heparin?
Multiply the control by 1.5 and then by 2.
What is the antidote for Warfarin?
Vitamin K
Why does Nitroglycerin work?
Because it dilates the blood vessels, so it decreases blood pressure and it can also cause hypotension (which is a side effect of it)
Differences between Heparin and Warfarin?
Route is different. Warfarin is given orally, Heparin is given parenteral.
There are two types of anticoagulants: those that can be administered only parenterally and those that can be administered only orally.
The parenteral anticoagulants – Heparin work by preventing the conversion of fibrinogen to fibrin.
The oral anticoagulants work by preventing the synthesis of factors dependent on vitamin K for synthesis: factors II (prothrombin), VII, VIII, IX, and X.
Two different laboratory tests, one for drugs administered orally and one for those administered parenterally, are therefore used to measure the therapeutic effects of these anticoagulants.
Warfarin = PT& INR, Heparin = PTT.
What is Alendronate and what does it treat?
It is a Biphosphate and it treats osteoporosis
Wat is important to know about Alendronate? (A Biphosphate)
Taking it with juice or coffee markedly reduces absorption
After taking the drug the patient must stay in an upright position for 30 minutes to facilitate drug delivery to the stomach and prevent esophageal irritations
What is a common adverse effect of Vancomycin?
Histamine release that results in “redman’s syndrome
What is Vancomycin used to treat?
MRSA
Most serious side effect of Vancomycin?
Ototoxicity and Nephrotoxicity
Patient education for Vancomycin
They need to get a periodic CBC when theyre taking it for a long period of time.
What are the steps in treating Blood Pressure?
- Thiazide Diuretic, which is first line therapy ,and if needed other first lone drugs may be added such asbeta blockers, ace inhibitors, ARBs, calcium channel blockers etc.
- Second line drugs might be needed if that is not sufficient. These would include vasodilators, alpha-2 stimulants, alpha 1 blockers, and peripheral antiadrenergics
What Vasopressor would you use for shock?
Dopamine
What is one of the main ACE inhibors?
Captopril
What does Captopril (ACE inhibitor) do?
Inhibits the angiotensin-converting enzyme needed to change the inactive angiotensin 1 to the active form angiotensin 2,
Thereby it prevents sodium and water retention, decreases peripheral resistance, and lowers blood pressure.
What is a major adverse effect of Captopril?
An ace inhibitor
Chronic cough
How do diuretics work and increase urination?
Blocks the absorption of water and things like chloride, sodium etc which causes them to be excreted in the urine
What cautions do you need to take for Lasix? (Furosemide)
Do not take with digoxin or an aminoglycoside, assess accesst to toilet
What are the contraindications for Trimeterene?
It allows potassium to be reabsorbed and sodium to be excreted. Do NOT give if they are already on a potassium sparing diuretic!
Avoid potassium rich food and supplements
Patient teaching for Triamtrene?
Avoid potassium rich food, taking potassium supplements, or using a salt substitute that contrains potassium chloride
Nursing considerations for Warfarin?
Because Vitamin K competes with Warfarin, high vitamin K levels can decrease warfarin’s effectiveness.
Avoid a diet rich in Vitamin K, especially green vegetables
Patient teaching for Wafarin?
Avoid foods rich in vitamin K like green vegetables
Take percautions to avoid falls
What lab data would you monitor for Warfarin?
PT & INR
Whatnis the target range for INR when on warfarin/anticoagulant therapy?
2-3
What is Pilocarpine used for?
Cholinergic agonist that is used for simple and acute glaucoma, preoperative and postoperative intraocular tension, mydriasis, and xerostomia
How does Bethanechol work?
Increases urinary output by stimulating muscarinic receptors in the detrusor muscle.
As the bladder contracts, the bladder’s capacity increases, which leads to urinarion
Also can cause defecation by stimulating the lower GI tract.
How do Anticholinergics affect the elderly?
Decreases sweating/ perspiration which causes dehydration & heat stroke
How does peripheral vascular disease effect drug absorption in the elderly patient?
Causes decreased blood flow which decreases the drug’s absorption
How are highly fat soluble drugs metabolized in order adults??
Fat soluble drugs result in an increased duration of action.
What does atropine treat?
Bradycardia, during CPR
What kind of meals should be consumed when taking anticholinergic drugs?
Low in fat
What is parkinson’s disease?
An imblance of acetylcholine, which means that dopamine’s levels go down. Its a lack of dopamine, combined with too much acetylcholine that causes the symptoms of parkinson’s disease
How do drugs treat parkinson’s disease?
Increase dopamine levels and allow there to be a balance between acetylcholine and dopamine
Why is Levadopa always given with Carbadopa?
To help it reach the brain by crossing the blood brain barrier. Caridopa does not reach the brain but it allows 10% of levodopa to reach the brain
How does Dantrolene work?
Is peripherally acting.
Dantrolene reduces the force of contraction of skeletal muscle inhibiting the RYR recep-tor, which in turn reduces the amount of Ca2+ released from the sarcoplasmic reticulum, thereby uncoupling (relax-ing) muscle contraction from excitation.
How does low albumin levels impact the elderly with drug therapy?
Overall, low plasma protein levels place older adults at increased risk of adverse effects from drug therapy.
This risk is especially high when the drug is normally highly protein bound.
An example is the anticonvulsant phenytoin (Dilantin), a highly protein-bound drug.
Polypharmacy further complicates the effects of decreased albumin levels in older adults.
Recall that highly protein-bound drugs compete for protein-binding sites even in younger patients.
When fewer sites are available to start with, and several drugs must compete for fewer sites, the drugs may be unable to locate a protein-binding site.
Ultimately, the effects of drug therapy increase because more free or unbound drug is available to be active.
Older adults - how does body fat percentage and lead muscle mass change?
Lean muscle mass decreaes and body fat increases
What do adrenergic antagonists do?
Lower vital signs, can produce cholinergic effects in GI like constipation, dry mouth headache etc
Side effect of Calcium Channel blockers ?
Constipation
What adverse effect can prozosin cause?
First dose syncope
Pregnancy changes
Drug excretion is greater
Inhaled drug absorption is greater
Drug metabolism in older adults?
Liver’s ability to metabolize drugs is reduced
Selective Toxicity
The ability to supress or kill an infecting microbe without injury to the host
